Spontaneous resolution and recurrence of a Chiari I malformation and associated syringomyelia

Sun, John C.; Steinbok, Paul; Cochrane, D. Douglas

doi:10.3171/spi.2000.92.2.0207

Cited by 33 publications

(24 citation statements)

References 17 publications

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“…Because spontaneous syrinx improvement has been reported, it is difficult to draw any conclusions from individual case reports. 5,14,16,24,29,32 Despite the theoretical basis for such a relationship, we did not find any association between elevated BMIs and risk of syrinx in our own series. On the basis of these findings and our own data, we suggest that no association between BMI and syrinx formation in patients with CM-I can be proven with the existing data.…”

Section: Discussioncontrasting

confidence: 36%

Impact of body mass index on cerebellar tonsil position in healthy subjects and patients with Chiari malformation

Smith¹,

Strahle²,

Kazarian³

et al. 2015

JNS

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OBJECT It is unclear if there is a relationship between Chiari malformation Type I (CM-I) and body mass index (BMI). The aim of this study was to identify the relationship between BMI and cerebellar tonsil position in a random sample of people. METHODS Cerebellar tonsil position in 2400 subjects from a cohort of patients undergoing MRI was measured. Three hundred patients were randomly selected from each of 8 age groups (from 0 to 80 years). A subject was then excluded if he or she had a posterior fossa mass or previous posterior fossa decompression or if height and weight information within 1 year of MRI was not recorded in the electronic medical record. RESULTS There were 1310 subjects (54.6%) with BMI records from within 1 year of the measured scan. Of these subjects, 534 (40.8%) were male and 776 (59.2%) were female. The average BMI of the group was 26.4 kg/m2, and the average tonsil position was 0.87 mm above the level of the foramen magnum. There were 46 subjects (3.5%) with a tonsil position ≥ 5 mm below the level of the foramen magnum. In the group as a whole, there was no correlation (R2 = 0.004) between BMI and cerebellar tonsil position. CONCLUSIONS In this examination of 1310 subjects undergoing MRI for any reason, there was no relationship between BMI and the level of the cerebellar tonsils or the diagnosis of CM-I on imaging.

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Section: Discussioncontrasting

confidence: 36%

Impact of body mass index on cerebellar tonsil position in healthy subjects and patients with Chiari malformation

Smith¹,

Strahle²,

Kazarian³

et al. 2015

JNS

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“…36,49 Rarely, spontaneous resolution of CM-I has been observed in adults 26,31 and children. 3,7,11,20,21,24,26,[29][30][31]41,42,50 In pediatric cases, the resolution of CM-I was associated with a "catching up" of growth of the posterior fossa calvaria with the rest of the skull, rather than an actual re-duction in the size or degree of tonsillar herniation. The majority of cases of spontaneous CM-I resolution in children were observed in asymptomatic patients, leading to the recommendation of conservative "watchful waiting" unless symptoms arise or radiographic features progress.…”

Section: Discussionmentioning

confidence: 99%

Resolution of syndromic craniosynostosis-associated Chiari malformation Type I without suboccipital decompression after posterior cranial vault release

Levitt¹,

Niazi²,

Hopper

et al. 2012

PED

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Chiari malformation Type I (CM-I) is associated with syndromic and nonsyndromic craniosynostosis in pediatric patients, and the surgical management of CM-I in such cases is controversial. Previous guidelines have recommended simultaneous cranial vault expansion and suboccipital decompression. However, spontaneous resolution of CM-I has been observed, and the combined procedure carries additional surgical risks. The authors report the case of a 6-month-old boy with Crouzon syndrome, CM-I, and a cervical syrinx who underwent posterior cranial vault release without suboccipital decompression. Imaging at the 3-month follow-up visit demonstrated complete resolution of the CM-I, improvement in CSF flow, and reduction in the size of the syrinx. This case suggests that up-front suboccipital decompression may not be necessary in patients with craniosynostosis and CM-I. A strategy of initial cranial vault release, followed by watchful waiting and radiographic surveillance, is proposed.

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“…Only 4 pediatric cases of spontaneous resolution of a spinal cord syrinx have been reported in the recent literature [1,6]. All these cases were associated with a Chiari type I malformation.…”

Section: Discussionmentioning

confidence: 99%

Successful Endoscopic Third Ventriculostomy in Noncommunicating Thoracic Syringomyelia

Cipri

Cafarelli

2002

Acta Neurochirurgica

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Spontaneous resolution and recurrence of a Chiari I malformation and associated syringomyelia

Cited by 33 publications

References 17 publications

Impact of body mass index on cerebellar tonsil position in healthy subjects and patients with Chiari malformation

Impact of body mass index on cerebellar tonsil position in healthy subjects and patients with Chiari malformation

Resolution of syndromic craniosynostosis-associated Chiari malformation Type I without suboccipital decompression after posterior cranial vault release

Successful Endoscopic Third Ventriculostomy in Noncommunicating Thoracic Syringomyelia

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